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Joaquin Vargas - 1600 Collins Avenue LLCi . 04)5? 600 MIAMI BEACH - City of Miami Beach Office of the City Clerk 1700 Convention Center Drive, Miami Beach, FL 331392013 FEB 19 AM 11: 41 LOBBYIST REGISTRATION FORM C i T`i,' C L L i`F i'S 0 F F (C E Lobbyist means all.persons employed or retained, whether paid or not, by a principal who seeks to encourage the passage, defeat or modification of any ordinance, resolution, action or decision of any commissioner; any action, decision, recommendation of the City Manager or any city board or committee; or any action, decision or recommendation of any city personnel during the time period of the entire decision-making process on such action, decision or recommendation that foreseeably will be heard or reviewed by the city commission, or a city board or committee. The term specifically includes the principal as well as any employee engaged in lobbying activities. The term"Lobbyists"has specific exclusions. Please refer to Ordinance 2004-3435. Vargas Joaquin NAME OF LOBBYIST: (Last) (First) (M.I) Traf Tech Engineering 8400 N. University Drive, Suite 309, Tamarac, FL 33321 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 954- 582-0988 954- 582-0989 ioaguin(cDtraftech.biz TE Please notify this office if your contact information changes:address,phone, or a-mail address. I. LOBBYIST RETAINED BY: 1600 Collins Avenue, LLC NAME OF PRINCIPAL/CLIENT: 1065 Kane Concourse, Suite 201 Bay Harbor Islands FL 33154 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) (305)866-7555 (305)866-7515 robertpfinvarb.com TELEPHONE NUMBER: FAX NUMBER:(Optional) EMAIL:(Optional) Fill out this section if principal is a Corporation, Partnership or Trust Section 2-482 (01 NAME OF CHIEF OFFICER,PARTNER,OR BENEFICIARY: Robert Finvarb G Y IDENTIFY ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION,PARTNERSHIP OR TRUST: II.SPECIFIC LOBBY ISSUE: Development approvals and permitting issues for one hotel proiect located at 1600 Collins Avenue, Miami Beach. Issue to be lobbied (Describe in detail): III. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED: Pursuant to City Code Section 2-482(a)(4)include the commissioner or personnel sought to be lobbied,and whether the lobbyist has entered into any contractual relationship (paid or unpaid) with said city commissioner or personnel from 12 months preceding such arson's commencement of service with the city to the present date,stating the general nature of the subject contractual relationship. Sec 2-482(a)(4)Full Name of Individual and Contractual Relationship(Explain) YES NO title of person to be lobbied Planning Department, Building Department and Public None Works Staff B, DRB, HPB, BOA, FP, City Commission, as one necessary* Pursuant to City Code Section 2-482(g)Every registrant shall be required to state the extent of any business,financial,familial or professional relationship,or other relationship giving rise to an appearance of an impropriety,with any current city commissioner or city personnel who is sought to be lobbied as identified on the lobbyist registration form filed. Sec 2-482(g)Any Financial,Familial or Professional Relationship None F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form.doc i IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR OTHER): A) LOBBYIST DISCLOSURE:(Required) B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION): (Required). The following information must be answered: 1) Pursuant to Miami Beach City Code Section 2-488 Entitled"Prohibited Campaign Contributions By Lobbyists On Procurement Issues": Yes X Nos you lobbying on a present or pending bid for good s.egui®went or servi ces.or on a present or®ending award for goods,eguipment or service? 2) Pursuant to Miami Beach City Code 2-490 Entitled"Prohibited Campaign Contributions By Lobbyists On Real Estate Development Issues": Yes X No: Are you lobbw'na on a pending application for a Development Agreement with the City or application for change of zoning map designation or change to the Gl13's EUIUL2 Land Use Mao? 3) Pursuant to Miami Beach City Code 2-484(h)Any person (except those exempt from the definition of"lobbyist" as set forth in Section 2-481 above) who only appears as a representative of a not-for-profit corporation or entity without special compensation or reimbursement for the appearance, whether direct, or indirect, to express support of or opposition to any item,shall register with the clerk as required by this section but,shall not be required to pay any registration fees. Yes X Now Are you representing a not-for-profit corporation or entity without special compensation or reimbursement. V. SIGNATURE UNDER OATH: 12hi EEBRIJARX 281b OF EACH YEAR, EACH LOBBYIST SU L SUBMIT TO IIJ Clj�QLER&A SiraNE12 STAIEMENT UbIDER EM THE EREQE01hjr2 GAL012AS YEAR. A 51A=Fb1T SHALL EVEN IF THERE HAVE BEEN EXPENDITURES OR CQIWPgbl§AIIQN 12WHINQ TIJE ffZQ"b1Q EF."IOD,— Sigr atur i of Lobbyist i I do solemnly swear that all of the foregoing facts a truel ang correct 'd t at:l ha a/ead or am familiar with the provisions contained in Section 2-482 of the Miami Beach City Code and II rep r en s. Signature of Lobbyist: Signature of Principal/Client: VI. LOBBYIST ID TIFICATIO PRINCIPAL IDENTIFICATION: Produced ID Produced ID Form of Identification Form of Identification Personally nown Lobb ' x Personally known Y "�"''�•, Jt,SEPH LAUDANDO . 1 MY WiMMISSION#EE 113366 (Principal)VII. ;= IXFIRES:August 5,2015 SIGNATURE AND STAMP OF P ) EE 3] '�%f1f��1�•.• bonded'f luu Ivo.ary Public Underwriters NOTARY: State of Florida, County of liewb State of Florida,County of Miami-Dade S "rnand subscrib d before me Swom�nd subscribed before me T is day of ®�� T ' day of �I 3 P i Sig ture of is o ate o orida Sig b li otary—State of Florida Notar tion of tobbsAsA.signature Notarization of Principal's signature TO BE COMPLETgQ BY CITY CLERK'S STAFF ONLY � Annual Registration fee: [ ]Yes[ ]No Amount Paid$ MCR# Date 7aicv�+ Lobbyist Registration Form received and verified by. 4 ® /\A I A City of Miami Beach, 1700 Convention Center Drive, Miami Beach,Florida 33139,www.miamibeachfl.gov CITY CLERK Office CityClerk @miamibeachfl.gov Tel: 305.673.7411 , Fax: 305.673.7254 LOBBYIST NAME: Joaquin Vargas I understand that no later than February 28th of each year, I must file the following form, pursuant to Section 2-485 of the Miami Beach City Code, with the City Clerk's Office for all active lobbying issues. 1) Lobbyist Expenditure and Compensation Form Failure to file these forms on a timely basis will result in my name being transmitted to the Miami-Dade County Commission on Ethics and for code violation evaluation. In addition, once an issue I have registered to lobby on has been resolved, I am required to immediately notify the City Clerk's Office of lobbyist withdrawal in writing. Pursuant to Section 2-485 (d), the City Clerk shall notify any lobbyist (or principal) who fails to timely file a Statement and in addition to any other penalties which may be imposed as provided in Section 2-485.1, a fine of $50.00 a day shall be assessed for all Statement(s) filed after the due date. The City Clerk shall notify the Miami-Dade County Commission on Ethics and Public Trust of the failure of a lobbyist (or principal) to file the Statement or pay the assessed fines after notification. Any lobbyist, who fails to file the required Statement by April 30th, 2012, shall be automat ally suspended from , lobbying until all fines are paid, unless the fine has been appeale to the Miami-Dad C unty Commission on Ethics and Public Trust. Sign a r Date: F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form.doc I 1 SSyi £ !tC. ;, +:• XU ..� 'S.'.. .w J. - - c ml Cash Receipt F . s }; M F R} - F .. _ CITY OF MIAMI BEACW ?4 " Cash 0 Credit Card Chec VQ� 2C aacelved of Ast€r - _ - For - f (THOS IOdFORMATOON MUST BE COMPLETED] Officejat Finance Ddrector ri j d rp rem _ �p • F� • ® t• f_ ?L'.- -r - ...v-' S .:'> 3 �•-s..'!' __ �L.. _ �.s.- � _ _ << ...,r' _ i ,.l.Iy,tT�x`5:•1_F ,.' J �� a.x., CITY OF MIAMI BEACH DEVELOPMENT REVIEW BARD APPLICATION DISCLOSURE OF INTEREST 1.-CORPORATION If the property which is the subject of the application is owned or leased by a CORPORATION, list the principal stockholders and the percentage of stock owned by each. Where the principal officers or stockholders consist of another corporation(s),-trustee(s), partnership(s) or other similar entity, further disclosure shall be required which discloses the identity of the Individual(s)(natural persons)having the ultimate ownership interest in the entity).* 1600 Collins Avenue,LLC, a-Delaware Company _1065 Kane Concourse,Suite 201,Bay Harbor Islands,FL 33154 Refer to Composite Ex)tibit B CORPORATION NAME and ADDRESS NAME,ADDRESS,AND OFFICE %OF STOCK Pgyid B. C.Martins,Managing Member 50% 1065 Kane Concourse,Suite 201 BaU Harbor Islands,FL 33154 _Sobe 1600,LLC,Managing Member 50% 1065 Kane Concourse Suite 201 Bau Harbor Islands,FL 33154 Sobe 1600,LLC 1065 Kane Concourse. Suite 201,Bau Harbor Islands,FL 33154 CORPORATION NAME and ADDRESS NAME,ADDRESS,AND OFFICE %OF STOCK RIF 1600.LLC . 50 1065 Kane Concourse,kite 201 Bau Harbor Islands,FL 33154 Juliette M.Kleupach as Trustee of the 50% Juliette M.K rev!20b trust 555 N.E.18511,Street Miami,FL 33179 RIF 1600 LLC 1 Q65 Kane Concourse,Suite 201,Bau Harbor Islands FL 33154 Robert Finvarl Family Investments 100% 1065 Kane Concourse,Suite 201 Bau Harbor Islands,FL 33154 Robert Finvarb Family Investments 1065 Kane Concourse,Suite 201,Bay Harbor Islands FL 33154 .R_obert and Rochelle 141nvarL,Managing Members 100%as 1065 Kane Concourse,Suite 201 tenants bu the entiretu Bat, Harbor Islands,FL 33154 IF THERE AREADDITIONAL CORPORATIONS,LIST OTHERS,INCLUDING CORP. NAMES)AND EACH INDIVIDUAL S NAME,ADDRESS,OFFICE AND PERCENTAGE OF STOCK,ON A SEPARATE PAGE. NOTE:Notarized signature required on page 8 6 I